# GRUPO CLINICO SAN JUDAS TADEO, P.S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548660525
- **Authorized official:** MR. JACOBO E QUINONES MD (DOCTOR/DIRECTOR)
- **Authorized official phone:** (787) 264-9111

## Contact information

- **Practice address:** TORRE SAN VICENTE DE PAUL SUITE 303, SAN GERMAN, PR 00683
- **Practice address phone:** (787) 264-9111
- **Practice address fax:** (888) 241-8086
- **Mailing address:** 187 CALLE SERENIDAD, URB. PARAISO DE MAYAGUEZ, MAYAGUEZ, PR 00680
- **Mailing address phone:** (787) 264-9111
- **Mailing address fax:** (888) 241-8086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 13577 | PR | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/27/2014
- **Last updated:** 01/21/2015